Press Releases Saturday 4 September 1999
No 7210 Volume 319

Please remember to credit the BMJ as source when publicising an
article and to tell your readers that they can read its full text on the
journal's web site (http://www.bmj.com).

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the source BMJ article (URL's are given under titles).


(1) DOCTORS ARE NOT GOOD AT GOING TO SEE THEIR
OWN DOCTOR!

(2) WOMEN IN ETHNIC MINORITIES MAY BE MISSING
BENEFITS OF HRT



(1) DOCTORS ARE NOT GOOD AT GOING TO SEE THEIR
OWN DOCTOR!

(Doctors as patients: postal survey examining consultants and
general practitioners adherence to guidelines)
http://www.bmj.com/cgi/content/full/319/7210/605

Most senior doctors (both general practitioners and consultants)
rarely go to see their primary care doctor and for many (over 70
per cent) prescribing for themselves and their families is the norm,
according to a study published in this week's BMJ. What is
needed to address doctor's health problems, say the authors from
the University of Kent, is access to a "doctor's doctor", possibly
based in the local hospital, who could also look after other NHS
staff and their families; an occupational health service for general
practitioners (GPs) and regular health check ups for all doctors.

Professor Malcolm Forsythe and colleagues studied the personal
use of health services of over 1150 GPs and consultants in south
east England, in accordance with the BMA guidelines on the
ethical responsibilities of doctors towards themselves and their
families. The study, say the authors, was conducted in the context
of a current picture of GPs and senior hospital doctors with high
levels of stress, anxiety and depression who take little time off
work for illness but who, when they are off work, tend to be off
for long periods.

Forsythe et al found that even though most (96 per cent) doctors
were registered with a GP they very rarely used their services. The
team also found that doctors were very reluctant to take time off
work due to illness and that this was particularly true of GPs and
female doctors. Despite their findings the authors also report that
doctors expressed support of the BMA guidance on their
responsibilities to their own health and that of their families.

The authors suggest that one of the reasons doctors are unlikely to
consult their own GP is because of difficulties of getting to see
them. They also say that with the high levels of psychosocial
problems among doctors, visiting their GP or local occupational
health service may not be perceived by doctor patients as the
appropriate confidential setting for consultation.

Forsythe et al conclude that there is a need for the provision of a
dedicated general practitioner service for doctors and their
families, as well as an "out of area" (ie not within the same
workplace) service, particularly for the treatment of psychosocial
problems and substance misuse. They say that these changes
together with provision of a consultant led occupational service to
cover all NHS staff, may improve compliance with the ethical
guidelines covering this area.

Contact:

Professor Malcolm Forsythe, Professorial Fellow in Public Health,
Centre for Health Services Studies, George Allen Wing, University
of Kent, Canterbury, Kent
Email: J.M.Forsythe-2@ukc.ac.uk

(2) WOMEN IN ETHNIC MINORITIES MAY BE MISSING
BENEFITS OF HRT

(Ethnic differences in use of hormone replacement therapy:
community based survey)
http://www.bmj.com/cgi/content/full/319/7210/610

Women of south Asian origin living in the UK are at increased risk
of coronary heart disease and osteoporosis and yet they are less
likely than white women to use hormone replacement therapy
(HRT), despite it being widely promoted as preventing these
conditions, report a team from St George's Hospital Medical
School in this week's BMJ.

Dr Tess Harris et al studied 882 white, African and South Asian
women aged 40-59 living in south London. White women were
more than twice as likely to be HRT users compared to South
Asian women (25% versus 10%) whereas women of Caribbean
or West African descent were intermediate in their use of HRT
(15%) say the authors. The differences in HRT use between ethnic
groups were not explained by differences in other factors
influencing HRT use including age and hysterectomy rates, they
say.

Harris et al claim that their findings are potentially important
because of the possible long term protective effects on heart and
bone, which may particularly benefit South Asian women with their
raised risk of coronary heart disease and osteoporosis. They
conclude that opportunities for health promotion amongst women
from ethnic minorities may be being missed and that further work
to explore the reasons for the differences is needed.

Contact:

Professor Derek Cook, Department of Public Health Sciences, St
George's Hospital Medical School, London
Email: d.cook@sghms.ac.uk


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